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Managing stress with Professor Mike Holmes

Mike [00:29:01] Yes. Thank you and thank you for inviting me to be part of this. So as Sonya said earlier, I’m a member of the Health and Wellbeing task force and specifically working on the primary care work stream. I’m vice chair of the RCGP with responsibility for membership and I’m leading their well-being offer. But at the heart of it all I’m a GP and I’m a partner with practices up in York and Hull, and I’m in York today talking to. 

Zoe [00:29:31] Thanks, Mike. So as a GP, when people come and see you, what are the signs and symptoms of stress? 

Mike [00:29:39] So we certainly do see a lot of people with symptoms of stress, and the key point that I would make is that it varies, everybody’s different. And they often have a range of different symptoms. But the key thing is that we can group those symptoms into sort of psychological symptoms, which would be things like low mood or anxiety, irritability, maybe detachment, just seeming sort of slightly vague, poor sleep. And also we get physical symptoms. So headaches, nausea, palpitations, maybe sweating. So the thing is, it is it can be difficult to spot, but as GPs we look for them and we see a lot of patients with it. And you can all look for these things both in yourselves and in your colleagues. 

Zoe [00:30:32] So when people come to you with these symptoms, what sort of strategies do you help people with? And is it different from what you provide for your patients, compared to what line managers or OD leads and HR leads. Is there a difference of what we can do, and what you can do as well? 

Mike [00:30:59] Think about things in a number of different ways. First of all, support and things you can do yourself, and then support you can get from those around you and then perhaps support you get from external resources. And I think if we start with self, what can you do for yourself? One of the things is just have permission, permission to put yourself first. And I think as carers, as healthcare professionals as non clinicians in healthcare, we tend to think about patients, particularly at times like this. But when dealing with stress, it’s OK to put yourself first. It’s OK to talk about it and it’s OK to talk about it in terms of supporting others. I think the other thing we do is look at the environment. So, you know, are we safe? Have we got the right sort of PPE? Are we social distancing? And if we’re working from home, can we work from home, have we got the right equipment? Are we working too many hours? You know, I think as team leaders, as colleagues, we can keep an eye on that and make sure we don’t overwork people and lead them towards burnout. 

Mike [00:32:06] And of course, it’s looking after yourself, thinking about your diet, whether you exercise, you’re connecting with friends and colleagues, taking regular breaks and making healthy choices, i.e., not choosing to to de-stress through things like alcohol or smoking or other drugs. That’s really, really important. And then, of course, signposting to the app. We’ve talked about the website already and there’s a number of free apps on there which might have helped people think about how they might look after them selves optimally. We also think about those around us. So those of us in teams, think about how you might blog within the team, write reports, write messages. You know, I wrote a message to all our practise staff on a weekly basis and they tell me that it’s helpful, they feel supported by it. Can we put together videos to help colleagues and just get that message out that it’s okay for people to ask, and it’s OK for people to talk about this. In fact, it must be talked about. 

Mike [00:33:10] And then modelling behaviours as leaders, as line managers, as team members. We can model these behaviours, ad hoc conversations with colleagues, positive psychology about the whole situation. And again, just being prepared to talk about embracing our own vulnerability and showing others that that’s not a weakness, that’s an absolute strength, particularly in situations like this. And then, of course, actually talking about it, we talk we’ve heard about line managers getting involved, talking to staff. We’ve tried buddying our staff. So giving people someone that they can go to, that they’ve got permission to go to. And the other thing we’re thinking about now are compassion circles or Schwartz rounds. And there’s a team in Bristol created a 20 minute address. And this is something that can be done virtually. We’re sort of trialling it in our practise and in general practise and it works really well. So, you know, five or six colleagues on a call, a facilitated discussion around what matters to them at this moment. What are they doing to help the situation? What do they need? What are they worried about? And I think that seems to be working really well. 

Mike [00:34:24] And then externally, I guess, look for support from your peer group, professional groups. At the Royal College we’ve got our younger GPs our newly qualified GPs our late career GPs all sending messages of support to the profession. And that’s a relatively straightforward thing to do. And we can also look at virtual forums, Whatsapp groups. I’m certainly a member of a few Whatsapp groups where we share learning, share questions, and that can really help to ease one’s anxiety about what’s going on around us. 

Mike [00:35:02] And then coaching, we’ve heard a little bit about what’s coming down the line in terms of coaching. I’m working on the primary care offer at the moment, and I think that’s going to be really, really valuable. So try and get plugged into the national offers that affect your work group and encourage your staff to take advantage of that. And then, of course, and sometimes further professional help is needed and it’s good to be aware of where colleagues can get that support. So whether that’s occupational health, whether that’s through the practitioner health program or indeed through your own GP, you know, we we were very well aware as GPs that all health care workers in the NHS have a GP and that we need to be there for them. And then, of course, specific therapy, you know, whether it’s counselling, CPD, or other forms of psychological treatments. They’re there for people if they need them. So I think that’s it really Zoe. It’s that  holistic perspective, you know, self, team and external resources. 

Zoe [00:36:08] Thanks, Mike. And that’s really helpful to me as an individual, but I think it is also helpful for line managers and other people who are supporting our health and care staff at this time. I like how you’ve broken down into these different areas where we can start to, you know, really look at the individual, understand the individual and put things in place, for the individual. So it’s really helpful. Thanks, Mike. 

Zoe [00:36:34] One final question for me. 

Zoe [00:36:35] What was your take home message? If there’s a couple of things that you’d like us really to take home and to think about after this seminar. What would you suggest we think about? 

Mike [00:36:46] Well, I think in terms of stress for me, I think it’s. Recognise it, acknowledge it, and talk about it. 

Key takeaways:

The signs and symptom of stress:

  • Psychological symptoms
    • Low mood/anxiety
    • Irritability
    • Detachment
    • Poor sleep
  • Physical symptoms
    • Headaches
    • Nausea
    • Palpitations
    • Sweating

What we can do as an individual, as part of a team, and other external resources to help combat the above symptoms:

What you can do as an individual:

  • It’s OK to put yourself first.
  • Look at the environment. Is it safe? Are we social distancing? if you’re working from home, are you working too many hours, do you have the right kind of equipment?
  • Are you exercising, eating well, taking regular breaks?

What you can do as part of a team:

  • Think about how you communicate with your team, and what that’s like to be on the receiving end of you.
  • Modelling behaviours as line managers, team members.
  • Positive psychology.
  • Being prepared to talk about embracing our own vulnerability.
  • Buddying staff, giving people someone they can go to.
  • Compassion circles or Schwartz rounds i.e. 5 or 6 colleagues communicating what matters to them at this moment, their worries, their needs.

What you can do externally:

  • Support from your peer group, professional groups.
  • Virtual forums like Whatsapp groups. Join or create a group and share learning, questions, feedback. This can really help to ease one’s anxiety about what’s going on.
  • Coaching. Take advantage of national offers that affect your workgroup.
  • Occupational health.
  • Therapy, counselling, CPD.

Try and be aware of stress, acknowledge it, and talk about it.

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